<!DOCTYPE html>
<html lang="zh-CN">
<head>
    <meta charset="UTF-8">
    <title>量表管理-随访模板管理</title>
    <meta name="viewport" content="initial-scale=1.0, maximum-scale=1.0, user-scalable=no" />
    <link rel="icon" href="../../img/favicon.png">
    <link rel="stylesheet" href="../../css/plugins/bootstrap-3.3.5.css" />
    <link rel="stylesheet" href="../../css/plugins/bootstrap-datetimepicker.css" />
    <link rel="stylesheet" href="../../css/plugins/bootstrap-material-design.css">
    <link rel="stylesheet" href="../../css/plugins/ripples.css">
    <link rel="stylesheet" href="../../css/plugins/jquery-ui.css">
    <link rel="stylesheet" href="http://cdn.bootcss.com/material-design-icons/2.2.3/iconfont/material-icons.css">
    <link rel="stylesheet" href="../../css/style-template-edit-form.css"/>
</head>
<body>
<div class="outer">
    <% include ../header.inc.html %>
    <% include ../left.menu.inc.html %>
    <div class="body-box">
        <div class="tab-list">
            <div class="tab-item">模板基本信息</div>
            <div class="tab-item">节点管理</div>
            <div class="tab-item active">量表管理</div>
        </div>
        <div class="inner-box">
            <div class="form-outer">
                <div class="fixed-bar">
                    <h4 class="title">
                        <a class="form-link" href="./edit-base.html">新建随访模板</a>
                        <strong> >> </strong>
                        <a class="form-link" href="./edit-base.html" id="returnBase">模板基本信息</a>
                        <strong> >> </strong>
                        <a class="form-link" href="./edit-base.html" id="returnNode">节点管理</a>
                        <strong> >> </strong>
                        <span class="form-title">量表管理</span>
                    </h4>
                    <div class="btn-group">
                        <a href="javascript:history.go(-1)"><i class="material-icons">&#xE5C4;</i></a>
                        <a href="javascript:;" class="btn btn-raised btn-info btn-sm operate-btn" id="submitForm">保存</a>
                        <a href="javascript:;" target="_blank" data-click="false" class="btn btn-raised btn-info btn-sm operate-btn" id="preview">预览</a>
                    </div>
                </div>
                <div class="form-box">
                    <form action="" class="form-form">
                        <div class="form-step">
                            <h5 class="form-title">1、量表基本信息</h5>
                            <div class="form-group is-empty">
                                <label for="inputName" class="col-md-1 control-label">量表名称</label>
                                <p class="col-md-4">
                                    <input type="text" class="form-control" id="inputName">
                                </p>
                                <p class="col-md-4 input-tips">
                                    如：血常规、家庭病史等
                                </p>
                            </div>
                            <div class="form-group is-empty">
                                <label for="inputWrite" class="col-md-1 control-label">修改权限</label>
                                <p class="col-md-4">
                                    <select id="inputWrite" class="form-control">
                                        <option value="0">患者填写</option>
                                        <option value="1">医生填写</option>
                                    </select>
                                </p>
                                <p class="col-md-4 input-tips">
                                    该表的修改权限
                                </p>
                            </div>
                            <div class="form-group is-empty">
                                <label for="inputRead" class="col-md-1 control-label">查看权限</label>
                                <p class="col-md-4">
                                    <select id="inputRead" class="form-control">
                                        <option value="0">医生和患者</option>
                                        <option value="1">仅医生</option>
                                    </select>
                                </p>
                                <p class="col-md-4 input-tips">
                                    该表的查看权限
                                </p>
                            </div>
                            <div class="form-group is-empty">
                                <label for="inputDescription" class="col-md-1 control-label">量表描述</label>
                                <p class="col-md-11 input-tips">
                                    （建议为该节点添加一些医嘱或其他内容来指导患者进行本次随访）
                                </p>
                                <p class="col-md-offset-1 col-md-11 description-textarea">
                                    <textarea id="inputDescription"></textarea>
                                </p>
                            </div>
                        </div>
                        <div class="form-step two">
                            <h5 class="form-title">2、输入项</h5>
                            <p class="empty-tips hidden">点击右下角按钮添加输入项</p>
                            <table class="table table-hover">
                                <thead>
                                <tr>
                                    <th>调整排序</th>
                                    <th>名称</th>
                                    <th>类型</th>
                                    <th>操作</th>
                                </tr>
                                </thead>
                                <tbody id="inputList">

                                </tbody>
                            </table>
                        </div>
                    </form>
                </div>
            </div>
        </div>
        <div class="operate-cover"></div>
        <div class="operate-box">
            <a href="javascript:;" class="main-btn" title="新增输入项"><i class="material-icons">&#xE145;</i></a>
        </div>
    </div>
    <div class="modal fade" id="addInput">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <table class="popuptable">
                            <tr>
                                <td class="first-td">
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputText" class="radio_check" checked/>
                                            文本型
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="适用于没有统计分析需求的内容"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputDate" class="radio_check"/>
                                            日期型
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="适用于生日或事件发生时间"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputValue" class="radio_check"/>
                                            数值型
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="适用于体征指标收集"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputImg" class="radio_check"/>
                                            图片型
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="适用于影像资料"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputVideo" class="radio_check"/>
                                            视频型
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="适用于视频资料"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputLongText" class="radio_check"/>
                                            长文本
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="不限字数的输入，如备注，诊断"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputDropdown" class="radio_check"/>
                                            下拉菜单
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="用于单选内容，但内容选项比较短的"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputRadio" class="radio_check"/>
                                            单选题
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="用于单选内容， 选项可以比较长"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputMultiselect" class="radio_check"/>
                                            多选题
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="用于多选内容， 选项可以比较长"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <tr>
                                <td>
                                    <div class="radio radio-primary">
                                        <label>
                                            <input type="radio" name="selectInput" data-type="inputSlider" class="radio_check"/>
                                            滑块（打分）题
                                        </label>
                                    </div>
                                </td>
                                <td class="inputTextTwo" title="适用于满意度调查，程度打分等题"><i class="material-icons">&#xE887;</i></td>
                            </tr>
                            <!--<tr>-->
                            <!--<td>-->
                            <!--<div class="radio radio-primary">-->
                            <!--<label>-->
                            <!--<input type="radio" name="selectInput" data-type="inputTag" class="radio_check"/>-->
                            <!--标签型-->
                            <!--</label>-->
                            <!--</div>-->
                            <!--</td>-->
                            <!--<td class="inputTextTwo" title="标签型"><i class="material-icons">&#xE887;</i></td>-->
                            <!--</tr>-->
                            <!--<tr>-->
                            <!--<td>-->
                            <!--<div class="radio radio-primary">-->
                            <!--<label>-->
                            <!--<input type="radio" name="selectInput" data-type="inputPlace" class="radio_check"/>-->
                            <!--地区型-->
                            <!--</label>-->
                            <!--</div>-->
                            <!--</td>-->
                            <!--<td class="inputTextTwo" title="地区型"><i class="material-icons">&#xE887;</i></td>-->
                            <!--</tr>-->
                            </tbody>
                        </table>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" id="nextStep">下一步</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputText">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="select1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="select1" placeholder="文本" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5  col-xs-5 text-describe" >
                                        适用于没有统计分析需求的内容
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="select2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="select2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe">
                                        希望患者输入的内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="文本" data-input-type="5" data-type="0">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputDate">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="date1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="date1" placeholder="日期" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        适用于生日或事件发生时间
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="date2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="date2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="日期" data-input-type="2" data-type="0">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputValue">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="value1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="value1" placeholder="数值" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        适用于体征指标收集
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="value2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="value2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="numUnit" class="col-md-2 col-xs-2 control-label text-right">单位</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="numUnit"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        指标项的单位：如um/L
                                    </div>
                                </div>
                                <!--<div class="form-group row">-->
                                <!--<label for="value4" class="col-md-2 col-xs-2 control-label text-right">长度</label>-->
                                <!--<div class="col-md-5 col-xs-5 md-input">-->
                                <!--<input type="text" class="form-control" id="value4"/>-->
                                <!--</div>-->
                                <!--<div class="col-md-5 col-xs-5 text-describe" >-->
                                <!--支持小数点后多少位，0到3（0为整数）-->
                                <!--</div>-->
                                <!--</div>-->
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label fourText text-right">指标监控</label>
                                    <div class="togglebutton col-md-10 col-xs-10">
                                        <label>
                                            <input type="checkbox" id="numToggle">
                                        </label>
                                        开启后，当患者指标不符合参考值范围时，将短信提醒医生
                                    </div>
                                </div>
                                <div class="max-min">
                                    <div class="form-group row">
                                        <label for="numMin" class="col-md-2 col-xs-2 control-label text-right">最小参考值</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control" id="numMin"/>
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            该指标的最小参考值
                                        </div>
                                    </div>
                                    <div class="form-group row">
                                        <label for="numMax" class="col-md-2 col-xs-2 control-label text-right">最大参考值</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control" id="numMax"/>
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe " >
                                            该指标的最大参考值，不能小于最小参考值
                                        </div>
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="数值" data-input-type="1" data-type="0">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputImg">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="img1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="img1" placeholder="图片" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        适用于影像资料
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="img2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="img2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="图片" data-input-type="7" data-type="0">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputVideo">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="v1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="v1"  placeholder="视频" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        适用于视频资料
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="v2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="v2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="视频" data-input-type="6" data-type="0">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputLongText">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="L1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="L1"  placeholder="长文本" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        不限字数的输入，如备注，诊断
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="l2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="l2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="长文本" data-input-type="5" data-type="1">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputDropdown">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label for="d1" class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="d1"  placeholder="下拉菜单" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        用于单选内容，但内容选项比较短的
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label for="d2" class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" id="d2"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                                <div id="dropMenu">
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control" />
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control"/>
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-12">
                                        <span class="add-option">增加选项</span>
                                    </div>
                                </div>

                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="下单菜单" data-input-type="3" data-type="1">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputRadio">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control"   placeholder="单选" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        用于单选内容， 选项可以比较长
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label  class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" />
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                                <div id="radioMenu">
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control"/>
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control" />
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-12">
                                        <span class="add-option">增加选项</span>
                                    </div>
                                </div>

                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="单选" data-input-type="3" data-type="0">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputMultiselect">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control"   placeholder="多选" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        用于多选内容， 选项可以比较长
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label  class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" />
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入的内容
                                    </div>
                                </div>
                                <div id="MultiselectMenu">
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control"/>
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control" />
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-12">
                                        <span class="add-option">增加选项</span>
                                    </div>
                                </div>

                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type="0" data-type-text="多选" data-input-type="4">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputSlider">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control"   placeholder="滑块" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        适用于满意度调查，程度打分等题
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label  class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title" />
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        希望患者输入内容
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label  class="col-md-2 col-xs-2 control-label text-right">最小值</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="sliderMin" onkeyup="value=value.replace(/\D/g,'')"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        每个题的最小分数
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label  class="col-md-2 col-xs-2 control-label text-right">最大值</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" id="sliderMax" onkeyup="value=value.replace(/\D/g,'')"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        每个题的最大分数，必须大于最小值
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label  class="col-md-2 col-xs-2 control-label text-right">计算汇总</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <div class="checkbox">
                                            <label>
                                                <input type="checkbox" id="calcTotal"> 求和
                                            </label>&emsp;
                                            <label>
                                                <input type="checkbox" id="calcAverage"> 平均
                                            </label>
                                        </div>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe" >
                                        为题目计分
                                    </div>
                                </div>
                                <div id="sliderMenu">
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control"/>
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                    <div class="form-group row">
                                        <label  class="col-md-2 col-xs-2 control-label text-right">选项</label>
                                        <div class="col-md-5 col-xs-5 md-input">
                                            <input type="text" class="form-control" />
                                        </div>
                                        <div class="col-md-5 col-xs-5 text-describe" >
                                            候选选项 <span class="delete-node">删除该项</span>
                                        </div>
                                    </div>
                                </div>
                                <div class="row">
                                    <div class="col-md-12">
                                        <span class="add-option">增加选项</span>
                                    </div>
                                </div>

                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-input-type="8" data-type="0" data-type-text="滑块">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputTag">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" value="标签" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5  col-xs-5 text-describe" >
                                        适用于体征指标收集
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe">
                                        希望患者输入内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="标签">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
    <div class="modal modal-input fade" id="inputPlace">
        <div class="modal-dialog">
            <form action="">
                <div class="modal-content">
                    <div class="modal-header">
                        <button type="button" class="close" data-dismiss="modal" aria-hidden="true">×</button>
                        <h4 class="modal-title">新增输入项</h4>
                    </div>
                    <div class="modal-body">
                        <div class="container-fluid">
                            <form  class="form-horizontal">
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">类型</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control" value="地区" disabled="disabled"/>
                                    </div>
                                    <div class="col-md-5  col-xs-5 text-describe" >
                                        适用于体征指标收集
                                    </div>
                                </div>
                                <div class="form-group row">
                                    <label class="col-md-2 col-xs-2 control-label text-right">名称</label>
                                    <div class="col-md-5 col-xs-5 md-input">
                                        <input type="text" class="form-control input-title"/>
                                    </div>
                                    <div class="col-md-5 col-xs-5 text-describe">
                                        希望患者输入内容
                                    </div>
                                </div>
                            </form>
                        </div>
                    </div>
                    <div class="modal-footer">
                        <button type="button" class="btn btn-raised btn-default" data-dismiss="modal">取 消</button>
                        <button type="button" class="btn btn-raised btn-info" data-type-text="标签">确 定</button>
                    </div>
                </div>
            </form>
        </div>
    </div>
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